This proposal aims to replicate and extend the findings of a study recently completed here. That study aimed to determine what benefits may be added to routine counseling services by professional psychotherapists. We found that significant benefits were added, especially for patients with high levels of psychiatric symptoms, and also that there were differences in outcome for different therapists. We propose to do the following study at our program and in two nearby methadone programs: Opiate addicts applying for a new episode of methadone maintenance treatment, who have psychiatric symptoms of an intensity and frequency greater than 50% of all new treatment applicants, who express an interest in the therapy program and who give informed consent will be randomly assigned to receive either two paraprofessional counselors, or a counselor plus a psychotherapist. Sixty patients per program will be randomly assigned, making a total of 180, or 90 per group. A comprehensive battery of evaluations will be done prior to entrance into the study, at 7 months post-intake (one month after the additional treatments end) and at 12 months. Comparisons between treatment groups, between progress obtained by individual therapists and between psychiatric symptoms, diagnoses and outcome will be made, according to methods used in our earlier work.